Provider Demographics
NPI:1639442023
Name:KURLAND, PAUL F (MA)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:F
Last Name:KURLAND
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SHAWANO AVE
Mailing Address - Street 2:SUITE 110W
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-3246
Mailing Address - Country:US
Mailing Address - Phone:920-499-6366
Mailing Address - Fax:920-499-2981
Practice Address - Street 1:1600 SHAWANO AVE
Practice Address - Street 2:SUITE 110W
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-3246
Practice Address - Country:US
Practice Address - Phone:920-499-6366
Practice Address - Fax:920-499-2981
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI26-156231H00000X, 231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner